Fibromyalgia 2016 criteria and assessments: comprehensive validation in a Norwegian population, 2020, Fors et al.

[Midnattsol]

Article about the new diagnostic criteria for fibromyalgia

Dagens Medisin had an article about the new diagnostic criteria for fibromyalgia, with comments from Egil Fors who have been involved in some ME/CFS research at NTNU.

https://www.dagensmedisin.no/artikler/2020/10/09/oppsiktsvekkende-funn-om-menn-og-fibromyalgi/
Google translate: https://translate.google.com/translate?hl=en&sl=no&tl=en&u=https://www.dagensmedisin.no/artikler/2020/10/09/oppsiktsvekkende-funn-om-menn-og-fibromyalgi

He seems to be explaining the central senzitation theory, and also mentions how men diagnosed with other disorders like Gulf War Illness may in fact have fibromyalgia. With the old diagnostic criteria the ratio between women:men who were diagnosed were 9:1, with the new criteria it is 2:1. (The quotes below are from Fors). Also something about the distinction of illness and disease.

- The old way of thinking was that fibromyalgia was an inflammation, or a rheumatic disease without inflammation. Now we think that it is a hypersensitivity in the nervous system that makes it difficult to regulate pain, explains Fors, who adds to Dagens Medisin that this is still debated between professionals.
...
What is most striking about the new fibromyalgia criteria, however, is the gender balance. Using the old diagnostic criteria, nine to one of those diagnosed was women.

- With the new criteria, the balance is two to one. Therefore, it is reasonable to believe that many men walk around with symptoms that sail under other flags. An example is the use of "gulf war syndrome" on veterans who experienced diffuse ailments, such as pain, difficulty concentrating and sleep problems, after the Gulf War. In fact, they had fibromyalgia.

No exclusion diagnoses
One of the most positive things about the new way of diagnosing is the recognition that one can have different degrees of fibromyalgia, from mild to severe type, as opposed to the old notion that one was either "sick or healthy" and that the disease can be cured.

- It is fine to recover from fibromyalgia, from severe to milder versions, and in some cases recover completely. The new criteria confirm that you can have other diseases and ailments as well, such as arthritis. Then you can treat arthritis in one way, and fibromyalgia in another and specific way. This makes it possible to tailor the treatment much more than before, says Fors.

- Is it a disease? [Journalist]

- Having to determine what is disease and what is not, is a difficult question. It is not always possible to find an explanation for the disease, even if you are ill. In this sense, one should perhaps in Norwegian also have distinguished between the terms "illness" and "disease".

Also mentions how we previously thought there were no objective markers but now we have found some (would CPM really be classified as "objective"?)

- A new recognition of fibromyalgia has now emerged. In contrast to before, it is now believed that there are in fact objective parameters in fibromyalgia patients that deviate in relation to healthy people, says the NTNU researcher, who continues:

- In fibromyalgia patients, there are several objective findings that may help to explain the ailments. For example, it is seen that people with fibromyalgia have some discrepancies compared to others when it comes to increased presence of a special substance in the spinal fluid that regulates pain, ie substance P.

- In addition, one can measure hypersensitivity in the nervous system in different ways. For example, if you inflict pain in the left hand of a healthy person, the pain will disappear if you expose another area, such as the right ankle, with more pain. This is called "conditioned pain modulation", CPM. This will not happen with fibromyalgia patients who have a reduced CPM compared to healthy controls.

- Finally, we have changed the cytokine profile and micro-CRP, substances that indicate stress and biological changes in the body and gene variants that express vulnerability to fibromyalgia. Therefore, one can no longer say that fibromyalgia is nothing. Those who believe so have not put themselves well enough into the knowledge. This is not nonsense, but complicated and multifactorial.

 

[Kalliope]

Moved post

Not sure if this is the best thread, but there's an article today in a Norwegian news site about an assessment of the Fibromyalgia 2016 criteria. I noticed it because one of the researchers, Egil Fors, is also known for a biopsychosocial approach to ME.

Dagens Medisin: Oppsiktsvekkende funn om menn og fibromyalgi
google translation: Striking findings about men and fibromyalgia

- The old way of thinking was that fibromyalgia was an inflammation, or a rheumatic disease without inflammation. Now we think that it is a hypersensitivity in the nervous system that makes it difficult to regulate pain, explains Fors, who adds to Dagens Medisin that this is still debated between professionals.
...

What is most striking about the new fibromyalgia criteria, however, is the gender balance. Using the old diagnostic criteria, nine to one of those diagnosed was women.

- With the new criteria, the balance is two to one. Therefore, it is reasonable to believe that many men walk around with symptoms that sail under other flags. An example is the use of "gulf war syndrome" on veterans who experienced diffuse ailments, such as pain, difficulty concentrating and sleep problems, after the Gulf War. In fact, they had fibromyalgia.
...

- In fibromyalgia patients, there are several objective findings that may help to explain the ailments. For example, it is seen that people with fibromyalgia have some discrepancies compared to others when it comes to increased presence of a special substance in the spinal fluid that regulates pain, ie substance P.

- In addition, one can measure hypersensitivity in the nervous system in different ways.

(...)- Finally, we have changed the cytokine profile and micro-CRP, substances that indicate stress and biological changes in the body and gene variants that express vulnerability to fibromyalgia. Therefore, one can no longer say that fibromyalgia is nothing. Those who believe so have not put themselves well enough into the knowledge. This is not nonsense, but complicated and multifactorial.


Here's the abstract of their publication:
Scandinavian Journal of Pain - Fibromyalgia 2016 criteria and assessments: comprehensive validation in a Norwegian population - 2020 - by Egil A. Fors et al

 

[Kalliope]

I wonder what treatment approaches Egil Fors is thinking of when he says it's fully possible to recover from fibromyalgia, from severe to milder versions, and sometimes complete recovery.

 

[rvallee]

The old way of thinking was that fibromyalgia was an inflammation, or a rheumatic disease without inflammation. Now we think that it is a hypersensitivity in the nervous system that makes it difficult to regulate pain

 

[alktipping]

and the new way of thinking has zero evidence also . peoples opinions used to destroy lives .